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Biomedical subjects

D James

Publications and source records attributed to D James.

194 records · Page 11Linked to original sources
PubMedDate not supplied

Factors associated with self-reported depression and self-esteem among school-going adolescents from a geographically defined region in Ireland.

BACKGROUND: Recent reviews indicate that mental health problems in the young are increasing. AIMS: To measure the prevalence of, and risk factors associated with, depression and low self-esteem among Irish post-primary students. METHOD: 1,428 students, randomly selected from a sample of post-primary schools, were given an anonymised questionnaire. Analyses included bivariate and multivariate logistic regression. RESULTS: Questionnaires were completed by 992 (69.9%) respondents. 206 (20.8%) had a high depression score. Being from a single parent family (OR 2.8, 95% CI 1.5-5.4, p<0.001); having low self esteem (OR 13.44 95% CI 8.9-20.3, p<0.001); being female (OR, 3.7, 95% CI 2.5-5.6 p<0.001) and having a low fitness level (OR 1.8, 95% CI 1.2-2.8 p<0.006) were independently associated with a high depression score. CONCLUSIONS: The level of self-reported depression was high among these respondents and risk factors identified include having low self-esteem, being female, being from a single parent family and having a low fitness level.

Adolescent↗
PubMedDate not supplied

Program monitoring for clinical practice. Specimen positivity across urine collection methods.

Urinalysis is a primary component of methadone programming. A clinic-based study was conducted to determine whether unsupervised urine collection is as reliable as other methods for detecting unauthorized drug use among methadone treatment clients. Drug positivity rates compared over a 30-week period revealed no significant differences as a function of collection method. Results confirm the efficacy of unsupervised urine collection using a heat sensitive strip or temperature indicator. Study findings also offer evidence to support clinical practice designed to ensure client privacy and dignity while maintaining standards for effective program monitoring.

Adult↗
PubMedDate not supplied

The efficacy and safety of valsartan compared with placebo in the treatment of patients with essential hypertension.

A multicenter, randomized, placebo-controlled, double-masked, parallel-group study was performed to compare the efficacy and safety of valsartan 20, 80, 160, and 320 mg with placebo in the treatment of patients with essential hypertension. A total of 736 adults with uncomplicated essential hypertension stages 1 to 3 were randomized to receive placebo or valsartan 20, 80, 160, or 320 mg daily for 8 weeks. Assessments were made at baseline, after 4 and 8 weeks of treatment, and 2 to 3 days after stopping treatment. The primary efficacy variable was change from baseline in mean sitting diastolic blood pressure (MSDBP). Other variables included change from baseline in mean sitting systolic blood pressure (MSSBP) and responder rates (ie, MSDBP < 90 mm Hg or decrease of > or = 10 mm Hg from baseline). All doses of valsartan produced statistically significant reductions in both MSDBP and MSSBP at end point compared with placebo. A dose-response effect was seen, although the incremental reduction in blood pressure with doses of valsartan > 80 mg was relatively small. Statistically significant differences in responder rates at end point were seen for doses of valsartan of 80 mg and above compared with placebo, whereas the responder rates for valsartan 20 mg was not significantly different from that for placebo. Safety and tolerability variables included data on adverse experiences, rebound hypertension, and clinical laboratory evaluations. Tolerability was good, with headache being the most common complaint and occurring most frequently in placebo patients. The incidence of dizziness was similar among the placebo (5.4%) and valsartan 20-mg to 160-mg groups (2.1% to 3.4%); there was an increase in the incidence of dizziness in the 320-mg group (9.3%). No cases of symptomatic orthostatic hypotension occurred. Analysis of rebound showed that 11.6% of patients receiving placebo and 16.6% receiving valsartan had an increase in MSDBP to baseline levels or above 2 to 3 days after stopping treatment. No clinically significant adverse experiences were noted after stopping treatment. There were no clinically or statistically significant changes in laboratory values during treatment. Thus valsartan proved to be both effective and safe in reducing blood pressure in adults with essential hypertension. The optimal dose range is 80 to 160 mg, given once daily.

Adult↗
PubMedDate not supplied

Absent right precordial R waves are associated with reduced left ventricular function and poor prognosis in patients with aortic stenosis.

Right precordial Q waves can be present in patients with aortic stenosis as well as in those with anterior myocardial infarction. In order to evaluate the relationship of right precordial Q waves to left ventricular function and prognosis in patients with aortic stenosis, we studied 49 such patients with no history of myocardial infarction, by means of ECG, clinical history and echocardiography. 15 (31%) patients had Q waves in both V1 and V2 and 34 (69%) did not. There were no differences in age (77+/-9.0 years vs. 78+/-9.7), follow-up time (15+/-9.0 months vs. 18+/-10), gender (female:male 8:7 vs. 15:19), aortic valve gradient on Doppler (70.0+/-20 mmHg vs. 71+/-20) and left ventricular mass (360+/-118 g vs. 320+/-80) between the two groups (all P=NS). Left ventricular shortening fraction (22+/-9.0% vs. 28+/-8.5, P<0.05), ejection fraction (51+/-15% vs. 62+/-12, P<0.01) and circumferential fibre shortening (0.8+/-0.3 circ/s vs. 1.0+/-0.3, P<0.0s) were all significantly reduced in patients with right precordial Q waves compared to those without. During a mean follow-up of 1.5 years, 9 out of 15 (60%) patients with right precordial Q waves died compared with only 5 out of 34 (15%) patients with a normal QRS pattern died (P<0.01). In summary, a right precordial QS ECG pattern is present in nearly 1/3 patients with aortic stenosis and is associated with impaired left ventricular systolic function and adverse prognosis.

Aged↗
PubMedDate not supplied

Mitochondria: regulating the inevitable.

Apoptosis is a form of programmed cell death important in the development and tissue homeostasis of multicellular organisms. Abnormalities in cell death control can lead to a variety of diseases, including cancer and degenerative disorders. Hence, the process of apoptosis is tightly regulated through multiple independent signalling pathways that are initiated either from triggering events within the cell or at the cell surface. In recent years, mitochondria have emerged as the central components of such apoptotic signalling pathways and are now known to control apoptosis through the release of apoptogenic proteins. In this review we aim to give an overview of the role of the mitochondria during apoptosis and the molecular mechanisms involved.

Apoptosis↗
PubMedDate not supplied

Comparison of unstimulated and stimulated behaviour in human fetuses with congenital abnormalities.

Unstimulated (passive) and stimulated behaviour [fetal heart rate (FHR) and movements (FA)] was studied in 32 normal fetuses and 10 fetuses with congenital abnormalities (CA). FHR and FA were recorded using a single 1.5-MHz ultrasound transducer and analysed by computer. A 5-second vibroacoustic stimulus (VAS) ('electronic artificial larynx') was used for the stimulation studies. Thus, passive and stimulated behaviour could be studied in a group of fetuses with known pathologies. One hour was used as the recording time for the passive studies and 20 min for the stimulation studies (10 min pre- and 10 min post-VAS). All CA fetuses had abnormalities of FHR and/or FA on recording passive behaviour compared to normal fetuses. However, 4 of the 10 fetuses with CA had responses to VAS that were within the normal range for both FHR and FA. We do not feel that computerised assessment of stimulated behaviour in fetuses with CA confers any advantage over analysis of passive behaviour.

Adult↗
PubMedDate not supplied

Predictive value of pleural effusions in fetal hydrops.

Twenty-eight cases of fetal hydrops are reported. A diverse aetiology was found. Fetal therapy was undertaken in 12 (42.9%). The overall survival rate was 36.8% (excluding elective terminations). However, when normal fetuses presenting from 20 weeks were considered, the survival rate was 64%. The results were combined with those of two other studies (making a total of 182 cases with fetal hydrops) to ascertain the value of pleural effusions in predicting outcome in such cases. In the 143 cases that did not end in a therapeutic termination of pregnancy, fetal pleural effusions predicted death (fetal or neonatal) with a sensitivity of 67%, a specificity of 53%, a positive predictive power of 68%, a negative predictive power of 52% and an overall accuracy of 62%.

Female↗
PubMedDate not supplied

Horner's syndrome after carotid endarterectomy--a case report.

Horner's syndrome is described in a patient with anisocoria and unilateral lid ptosis 48 hours after an ipsilateral carotid endarterectomy. This case illustrates a rare iatrogenic complication of sympathetic nerve dysfunction following elective surgery.

Aged↗
PubMedDate not supplied

Monitoring the biophysical profile.

The fetal biophysical profile assesses fetal wellbeing. It is influenced by both physiological factors, e.g. gestational age and behavioural state, and pathological factors, e.g. asphyxia, infection, cardiovascular disease and neurological problems.

Female↗